The spine journal : official journal of the North American Spine Society
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Diurnal changes in T2 values, indicative for changes in water content, have been reported in the lumbar intervertebral discs. However, data concerning short-term T2 changes are missing. ⋯ A shift of water from the anterior to the posterior disc regions seems to occur after unloading the lumbar spine in the supine position. The clinical relevance of these changes needs to be investigated.
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Implants subsidence is a frequent complication of interbody fusion, which can result in pain, deformity, nerve damage, and even failure of surgery. The end plates as the interface between implants and the vertebral bodies play a very important role in sharing the compression on the vertebral bodies. The information on the structural property distribution of the end plate and its relationship with bone mineral density (BMD) and disc degeneration will be of great significance for the reduction in implants subsidence and improvement in related operative procedures to increase the success rate of interbody fusion. ⋯ Preoperative evaluation of the states of intervertebral discs and BMD of patients is necessary for predicting risks of implants subsidence after interbody fusion. For patients with or without disc degeneration or osteoporosis, the implants should be placed at the peripheral regions, especially the posterolateral sites, to acquire higher mechanical strength to reduce subsidence as much as possible.
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Comment
Commentary: revision lumbar surgery and revisiting the role of preoperative depression screening.
Adogwa O, Parker SL, Shau DN, et al. Preoperative Zung Depression Scale predicts outcome after revision lumbar surgery for adjacent segment disease, recurrent stenosis, and pseudarthrosis. Spine J 2012;12:179-85 (in this issue).
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Lee MJ, Konodi MA, Cizik AM, et al. Risk factors for medical complication after spine surgery: a multivariate analysis of 1,591 patients. Spine J 2012;12:197-206 (in this issue).